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why v-wave is typically accentuated in mitral insufficiency?


ā€˜vā€™ wave → passive filling of RA during RV systole while tricuspid valve is closed. In Mitral sufficiency blood further regurgitates into right atrium causing the jugular venous pressure to rise and resulting in accentuation of v wave.


In mitral insufficiency, blood should further regurgitate to left atrium instead of right atrium. isn't it? so why does it cause v-wave?


As said above:
V wave is systolic filling of R atrium, tricuspid valve is closed, beginning of S2, terminates when tricuspid valve opens.

Ican only say these facts:

Mitral regurg- giant c and v waves
Mitral Stenosis-no a wave


oops by mistake I said in mital regurgitation blood regurgitates into right atrium....apologies. I am waiting for someone to come up with the explanation of accentuated v wave in mitral insufficiency.


you know, i think this question is describing a pulmonary arterial wedge pressure that is measuring from the left side. it's the only reasonable answer. also, in mitral (or tricuspid) stenosis, the a-wave is elevated, not diminished. the a-wave would be more likely to be attenuated in valvular insufficiency, i think.


Its always great to ask why, but for usmle I think its best to know what happens normally at the a,c,v waves and how the waves appear with pathology.(eg. stenosis or regurg). {In other words have both graphs imprinted on the brains cells} I rest my case.


given, but i do believe that it's an enhanced a-wave in tricuspid stenosis.


Hi all,

I am not sure but I think they are talking about measurements of PCWP rather than Jugular venous pressure.


I too agree it's giant a wave in Mitral Stenosis. it's normal to have an increase in venous pressure when the atrium struggles to push the blood thru a narrow valve...

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